Mobility & Accessibility Transportation Survey

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Mobility & Accessibility Transportation Survey

Mobility & Accessibility Transportation Survey

Instructions: Please answer all questions on this survey. Thank you for your participation.

Medical, Behavioral, or Personal Services Providers - Begin at Section 2
Community and Entertainment Providers - Begin at Section 3
Elected Officials and Government Administration - Begin at Section 4

SECTION 1. GENERAL TRANSPORTATION

SECTION 2: MEDICAL, BEHAVIORIAL, AND PERSONAL SERVICES PROVIDERS

SECTION 3: COMMUNITY & ENTERTAINMENT PROVIDERS

SECTION 4: ELECTED OFFICIALS & GOVERNMENT ADMINISTRATION

Contact Us

Name:

Email:

1. Are you currently able to drive?

Yes

No

2. If you are able to drive, to which of the following local destinations do you drive? (Select all that apply)

Shopping, Grocery Store, Bank

Medical/Dental Appointments

Social Outings (to see friends or family, restaurant, golf, etc.)

School/Classes

Not notified about appointment Work

Religious Services

I don’t drive to any destinations

3. If you are able to drive yourself, what challenges have you experienced during the past three (3) months? (Select all that apply)

Unreliable car/truck; needs repairs

Cost of gas

Don’t like driving at night

No driver’s license or license suspended

Disability or other physical/cognitive limitation that restricts driving

Cannot afford/no car insurance

Don’t own a car/truck

Don’t like driving at any time

No difficulties in driving myself

Other (explain in comment section)

4. During the past three (3) months, were you unable to travel to any of the following destinations because you did not have access to transportation (either your own vehicle or a ride)? (Select all that apply)

Grocery shopping

Bank

Religious Services

Other Shopping

Medical Appointments

School or Classes

Pharmacy

Other Appointments

To see family/friends

None, I always have a way to get where I need to go

Other (explain in comment section)

5. During the past three (3) months, how often are you unable to get where you need to go because of not having a way to get there?

Rarely or infrequently

Several time in the past three (3) months

About once a month

More than once a month

Once a week or more often

6. What type of transportation have you used in the past three (3) months? (Select all that apply)

I use my own vehicle

Medicaid Transportation

Public Transit

Office for Aging bus

Walk

Bicycle

Taxi

Lyft/Uber

Rides from friends or family

Other (explain in comment section)

7. During the past three (3) months, what barriers to reliable transportation do you experience? (Select all that apply)

Cost of public transit

Cost of taxi/private transportation

No driver’s license or license suspended

Lack of access to a vehicle

Not comfortable driving/cannot drive

Cannot afford/no car insurance

Disability or other physical/cognitive limitation that restricts driving

Canceled trips through Medicaid

Public transportation not accessible

Don’t feel safe using public transportation

Don’t know how to use public transportation

Cost of gas

Don’t have someone to drive me

Unable to afford car repairs

None, I haven’t experienced any barriers during the past three (3) months

Other (explain in comment section)

8. If you experience transportation barriers, how do these affect you? (Select all that apply)

Limits my ability to work outside the home

Limits my ability to shop for food

Can’t do errands when I need to

Can’t attend church, other religious services

Isolation/Feel alone or sad

Limits my ability to shop for household needs

Limits my ability to go to school

Can’t go to social outings

Skip or don’t schedule medical appointments

Do not have any transportation obstacles

Other (explain in comment section)

9. Have you had difficulty find a ride to a medical appointment in the past three (3) months? If yes, please select all reasons that apply:

I need a wheelchair accessible vehicle

I don’t know who to call to request a ride

There are no rides available when I call

I have to wait too long for a ride back home after my appointment

I don’t have enough money for public transit fee

My friends and family are not available to take me

I can’t get a ride at the time I need to go

Other (explain in comment section)

10. How many times in the past three (3) months have you had to cancel a medical appointment due to lack of transportation?

Terrell

1

2

3

4

5

6 or more

11. If you depend on others for any of your trips, who do you depend on? (Select all that apply)

Spouse

Children/Other relatives

Friends/Neighbors

Private Services (e.g. Taxi)

Public Transportation System (SWGRT or DARTS)

Medicaid Transportation

Office for Aging Bus

Volunteers (from churches or non-profit organizations)

Other (explain in comment section)

12. Over the past three (3) months, how much did you rely on others for transportation?

Rarely or infrequently Another adult family member

Several times in the past three (3) months

About once a month

More than once a month

Once a week or more often

13. Who lives with you? (Select all that apply)

Spouse/Partner/Significant Other

Children under age of 18

Adult children 18 years or older

Parent(s) and/or Parent(s)-in-laws

New Option

Roommate/unrelated adult

Live alone

Other (explain in comment section)

14. Do you identify as a person with a disability or other physical or cognitive/intellectual limitation?

Yes

No

Prefer not to say

15. Does anyone who lives with you identify as a person with a disability or other physical or cognitive/intellectual limitation that affects their ability to drive?

Yes

No

Prefer not to say

16. What is your age?

Under 18

18-24

25-34

35-44

45-59

60-64

65+

17. What county do you live in?

18. Are you currently employed?

Yes

No

19. What prevents you from using the Southwest Georgia Regional Transit System (SWGRT)? The Southwest Georgia Regional Transit System (SWGRT) provides public transportation services to all residents within its 14-county service region. Operating six days per week with 76 participating buses, SWGRT has been serving the community for 24 years to ensure accessible and reliable transit options for all. Please select all reasons that may prevent you from using SWGRT:

Language barrier

Cost/Too expensive

SWGRT does not go where I need to travel

SWGRT buses are often not on time

The system is too confusing to use

No SWGRT service is available to me or in my area

I do not feel safe using SWGRT

I have experienced poor customer service with SWGRT

I would be too embarrassed to use SWGRT

None, I currently use SWGRT

Other (explain in comment section)

20. Please use this space for comments or service suggestions.

21. What type of services do you provide?

Primary Health Services

Specialized Health Services

Behavioral or Mental Health Services

Personal Services (e.g. barber, nail technician, cosmetics)

Other (explain in comment section)

22. What age range of clients do you typically serve? (Select all that apply)

Infant/Toddler

Children/Pre-teenager

Teenager

Young Adult

Adults 25–40

Adults 40–65

Adults 65 or older

23. What gender of clients do you typically serve? (Select all that apply)

Female

Male

24. What type of location do you practice from? (Select all that apply)

Stand-alone building

Business Park or Strip Mall

Shared Medical Office

Hospital

Mobile Unit

House Calls

25. How do clients make appointments when scheduling? (Select all that apply)

Client to office phone call

Client to office internet/app scheduler

Caregiver to office phone call

Caregiver to office internet/app scheduler

Referral from one doctor’s office to another

Walk-in appointments

Other (explain in comment section)

Free Text

26. Missing appointments: Please fill in the blank.

Is there a specific day(s) of the week when you see missed appointments?

Outside of natural disasters, are there weather conditions or seasons when you have more than normal missed appointments?

Are missed appointments tied to appointment type? (e.g. New client, follow-up, sick client)

27. Missing appointments: What are the reasons given for missing appointments? (Select all that apply)

Lack of childcare

Lack of transportation

Insurance issues

Financial issues

Work

Felt better

New Option

Forgetting about appointment

Personal emergency

Other (explain in comment section)

28. Transportation Related Losses: Has lack of transportation services caused business/service loss?

Yes

No

Maybe/Unsure

29. In which county are you located? (Select all that apply)

Baker

Calhoun

Colquitt

Decatur

Dougherty

Early

Grady

Lee

Miller

Mitchell

Seminole

Terrell

Thomas

Worth

30. Would you be willing to expand on these answers to help us get a true sense of the issues by having a one-on-one call with someone from our office?

Please leave any comments in this space for questions with the option "other".

Free Text

31. What type of services, events, projects, or other community functions do you provide?

32. What age ranges are your services, projects, etc. available for? (Select all that apply)

Infant/Toddler

Children

Pre-Teen

Teenager

Young Adult

Adults 25–40

Adults 40–65

Adults 65 or older

33. Are your services, events, projects, etc. available for disabled community members? (Select all that are available)

Hard of Hearing

Hard of Seeing or Blind

Mobility Encumbered

Orthopedic Impairment

Intellectual Disability

Mental or Emotional Illness

Speech or Language Impairment

Other (explain in comment section)

34. Do you currently have specific programs, events, or projects designed for disabled community members?

Yes

No

35. Are your services, events, projects, etc. available for aging and elderly community members?

Yes

No

36. Do you currently have specific programs, services, events, or projects designed for aging and elderly community members?

Yes

No

37. Is transportation for your disabled community members a barrier for participation in your services, events, projects, etc.?

Never

Rarely

Sometimes

Often

Always

38. Is transportation for your aging and disabled community members a barrier for participation in your services, events, projects, etc.?

Never

Rarely

Sometimes

Often

Always

40. Please add any additional thoughts, comments, or suggestions.

Free Text

Enter your free text here

40. What county do you live in?

41. How accessible do you think public spaces like parks, walking trails, and sidewalks are for community members with mobility disabilities?

None

Few

Some

Most

All

42. Do you believe your public spaces like parks, walking trails, and public sidewalks, are accessible for your aging and elderly community members?

None

Few

Some

Most

All

43. What barriers to transportation for town amenities including parks, recreation, and businesses do you believe your mobility and behavioral disabled communities have?

Cost of public transit

Public transportation not accessible

Cost of taxi/private transportation

Don’t feel safe using public transportation

No drivers license or license suspended

Don’t know how to use public transportation

Cost of gas

Not comfortable driving/cannot drive

Don’t have someone to drive them

Cannot afford car insurance

44. What barriers to transportation for town amenities including parks, recreation, and businesses do you believe your aging or elderly communities have?

Cost of public transit

Public transportation not accessible

Cost of taxi/private transportation

Don’t feel safe using public transportation

No drivers license or license suspended

Don’t know how to use public transportation

Cost of gas

Not comfortable driving/cannot drive

Don’t have someone to drive them

Cannot afford car insurance

45. What reasons may prevent these targeted populations from using the Southwest Georgia Regional Transit System? The Southwest Georgia Regional Transit System provides public transportation services to all residents within its 14-county service region. Operating six days a week with 76 participating buses, SWGRT has been serving the community for 24 years to ensure accessible and reliable transit options for all. Please select all reasons that may prevent these targeted communities from using SWGRT?

Language barrier

Cost/Too expensive

Poor customer service

SWGRT does not go where they need to travel

SWGRT buses are often not on time

The system is too confusing to use

Would be too embarrassed to use SWGRT

Do not feel safe using SWGRT

Other (explain in comment section)

46. Please use this space for comments or service suggestions.

Thank you for contacting us.
We will get back to you as soon as possible.

Oops, there was an error sending your message.
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“This survey was developed with funds provided by the National Aging and Disability Transportation Center (NADTC). The NADTC is administered by Easterseals and USAging, with funding from the Federal Transit Administration and guidance provided by the Administration for Community Living.”

Southwest GA Regional Commission assures that no person shall, on the basis of race, color, national origin, age, disability, family or religious status, as provided by Title VI of the Civil Rights Act of 1964, Federal Transit Laws, 49 CFR Part 21 Unlawful Discrimination, Nondiscrimination In Federally-Assisted Programs Of The Department Of Transportation and as per written guidance under FTA Circular 4702.1B, dated October 2012, be excluded from participation in, denied the benefits of, or be otherwise subjected to discrimination or retaliation under any program or activity undertaken by the agency.

181 E. Broad Street

Camilla, Georgia 31730

Phone: 229.522.3552

Fax: 229.522.3558

Email: info@swgrc.org

EIN : 58-0940910

E-verify #52681

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